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The ASA physical status classification system is a system for assessing the fitness of patients before surgery. In 1963 the American Society of Anesthesiologists (ASA) adopted the five-category physical status classification system; a sixth category was later added.
It is safe to perform sedation in the emergency room on patients who are ASA 1 or 2. If the patient is ASA 3 or 4 additional resources might be needed, such as a person with more training in procedural sedation, an anesthesiologist. [1] Furthermore, before a qualified anesthesia professional performs PSA, an Informed consent should be completed ...
The American Society of Anesthesiologists defines the continuum of sedation as follows: [9] Minimal sedation – normal response to verbal stimuli. Moderate sedation – purposeful response to verbal/tactile stimulation. (This is usually referred to as "conscious sedation") Deep sedation – purposeful response to repeated or painful stimulation.
This level, called moderate sedation/analgesia or conscious sedation, causes a drug induced depression of consciousness during which the patient responds purposefully to verbal commands, either alone or accompanied with light physical stimulation. Breathing tubes are not required for this type of anesthesia. This is twilight anesthesia. [2]
Mild or moderate sedation can be induced with medications such as midazolam (a benzodiazepine with sedating, amnesiac qualities), fentanyl (an opioid), or propofol (a sedative/general anesthetic, depending on dosage). Children are anesthetized. Adults are sometimes anesthetized as well if moderate sedation is unsuccessful. [citation needed]
ASA is governed by its House of Delegates. The House of Delegates is composed of ASA delegates and directors (designated by geographic distribution), ASA officers, all past presidents, the Editor-in-Chief of the journal, the chairs of all sections, the chair of the ASA delegation to the American Medical Association House of Delegates and each member of the Resident Component Governing Council ...
The original scoring system was developed before the invention of pulse oximetry and used the patient's colouration as a surrogate marker of their oxygenation status. A modified Aldrete scoring system was described in 1995 [2] which replaces the assessment of skin colouration with the use of pulse oximetry to measure SpO 2.
Minimum alveolar concentration or MAC is the concentration, often expressed as a percentage by volume, of a vapour in the alveoli of the lungs that is needed to prevent movement (motor response) in 50% of subjects in response to surgical (pain) stimulus.